1. Field of the Invention
This invention relates to mouth guards and mouth props for use in electro-convulsive therapy (ECT).
2. Description of the Related Art
During shock therapy (electro-convulsive therapy), a portion of the stimulus current passes through the muscles of mastication, resulting in the forcible contracture of the jaws for the duration of the stimulus. This contracture may result in fracture or other damage to the teeth. The type and extent of damage is affected by the health of the teeth and the pressure on the teeth. Thus, when patients lack some of their teeth, there are fewer teeth to distribute the loading stress and an element of support and stabilization for the adjacent and opposing teeth is absent. Inadvertent damage to the teeth may have serious cosmetic, functional and/or medicolegal significance. In addition to damage to the teeth, uncontrolled jawlock may cause damage to soft tissue such as the tongue, cheek buccal mucosa, lips and muscles from bites or impingements; damage to the temporomandibular joints and muscle of mastication from strain or dislocation or over extension or over flexion; and entry of debris, blood and other material into the respiratory system.
Many different mouth guards have been designed to prevent tooth and mouth injury to patients who are receiving ECT. Some of these guards also have features particularly useful in keeping the throat of an ECT patient from becoming obstructed. Many of the prior mouth guards have complicated structures to accomplish these purposes.
The early patent of Freedland (U.S. Pat. No. 2.459,273) is for a shock therapy mouth guard with a rubbery pad mounted between the ends of a rigid handle. A longitudinal passage is formed on top of the handle on the pad. The lower teeth of a patient are placed between two arcuate projections on the lower surface of the pad. The disclosure of this patent and all other patents and publications cited herein is hereby incorporated herein by reference.
Some of the tooth guards have elaborate molded flanges for protection of the front teeth and an attached breathing tube (See U.S. Pat. Nos. 2,669,988 of Carpenter; 2,882,893 of Godfroy; and 4,112,939 of Blachly). Others are simpler in form, being essentially V-shaped (U.S. Pat. No. 4,867,147 of Davis) or Y-shaped (U.S. Pat. Nos. 2,694,397 of Herms and 4,944,947 of Newman).
Even simpler is the disposable BITE.TM. jawlock of U.S. Pat. No. 3,971,370 which is simply a tongue depressing stick with a polyethylene foam pad at one end. For use in ECT, one of the BITE.TM. jawlocks is placed on each side of the oral cavity, but because the BITE.TM. jawlock does not fill the oral cavity, it is often difficult to keep the two jawlocks in the correct place to prevent patient injury.
Other mouth guards are particularly designed for use by athletes, and are primarily made to surround and protect all of the player's teeth, for example, U.S. Pat. Nos. 3,496,939 of Gores and 5,082,007 of Adell. Other mouth guards are designed for use by persons undergoing operations requiring intubation, for example, U.S. Pat. No. 3,513,838 of Foderick, or to firmly depress and hold a patient's tongue, for example, U.S. Pat. No. 4,041,937 of Diaz.
It is important that mouth guards used for ECT be both inexpensive to construct so that they can be disposable; be able to fit all patients, i.e, with different sizes of oral cavity or different numbers and arrangements of remaining teeth using a minimum number of mouth guard models; provide sufficient cushioning to minimize tooth damage; and allow the anesthetized patient to be ventilated while the mouth guard is positioned in the oral cavity. The prior mouth guards generally are deficient in one or more of these aspects.
It is therefore an object of this invention to provide a mouth guard for ECT which can be manufactured inexpensively. The mouth guard of the invention may also be used for numerous other procedures, including, for example, procedures requiring positioning of the maxilla and mandible for a period of time, film studies, magnetic resonance studies, and other procedures.
It is a further object of this invention to provide a mouth guard which can be used by patients having any one of a number of mouth sizes and which accommodates a varied number and arrangement of remaining teeth.
It is a further object of this invention to provide a mouth guard which is effective in minimizing tooth damage and other damage to the patient.
It is a further object of this invention to provide a mouth guard which allows a patient to be ventilated while the mouth guard is in the patient's oral cavity.
Other objects and advantages will be more fully apparent from the following disclosure and appended claims.